254: Electrocardiographic Infarct Pattern Early Following Cardiac Transplantation: Prevalence and Prognostic Implication

Abstract

heart transplants during this period. Ten of the CHKTx were performed simultaneously and 2 as a staged procedure using the same donor for both organs. Pretransplant left ventricular ejection fraction was 27.5 16 and creatinine clearance was 31 11 mL/min. Five patients underwent pretransplantation dialysis. Results: There was no operative mortality. Mean follow-up time was 49 36 months. Patient survival rates for the CHKTx recipients at 1 and 3 months were 91% and 83% respectively and had not changed during a follow up period. Survival rates for isolated heart transplantation (IHTx) recipients at 1, 3 months, 3 and 7 years were 97%, 95%, 87% and 79% respectively (p 0.61). Eight patients showed no evidence of significant (IHLT grade2) cardiac allograft rejection. The freedom from rejection at 3 months was 73% for CHKTx and had not changed further; for IHTx freedom from rejection at 3 months, 1 year and 6 years was 61%, 56% and 42%. (p 0.19) Heart and renal allograft survival was 100% with LVEF 66% 8.4 and creatinine clearance 61 25 at last follow-up. Conclusions: CHKTx using organs from the same donor yields favorable long-term outcome with a low incidence of cardiac and renal allograft rejection. Immediate kidney transplantation without delay after heart transplantation appears favorable, if cardiac function and hemodynamics are satisfactory. This approach effectively expands the selection criteria for transplantation in potential candidates with coexisting end-stage cardiac and renal disease.